What is ASA?

• Paramedics administer ASA to patients experiencing signs and symptoms of cardiac ischemia ​
• ASA works by inhibiting cyclooxygenase enzymes (mainlyCOX-1 and COX-2)​
• COX-1 produces Thromboxane A-2 which causes platelet aggregation (clotting)​
• Therefore, ASA inhibits platelet aggregation​
• With ASA circulating throughout the bloodstream the chances of a new clot forming or an old clot growing is decreased.

What if the patient has already had ASA administered?

• According to the ISIS-2 trial (Lancet, 1988), ASA decreased the mortality in patients experiencing ACS by 23%​
• Due to the benefits of ASA in patients experiencing symptoms of cardiac ischemia, your patient may still benefit from ASA administration, even if it was administered prior to your arrival​
• This may include patient or family self-administration, or health care clinic or office administration

Rationale for more ASA

• Ensures the patient gets the appropriate dose of ASA​
• Was the dose taken expired?​
• Was it truly ASA?​
• No harm in getting an extra dose​
• Therapeutic dosing may be up to 1500mg (that is 18 tablets of 80-81mg ASA).

Summary:

• ASA has been found to decrease mortality and is therefore a helpful treatment in suspected cardiac ischemia ​
• Paramedics are encouraged to provide ASA even if the patient has already had this medication administered​
• Rationale: ​You ensure the patient gets the dose and medication we know helps save lives in cardiac ischemia​
• The therapeutic range (1500mg) is far above what an additional dose (or two) would be​
• This includes patient self-administration as well as healthcare provider administered ASA

No additional resources available for this #SWORBHPTip.